HomeMy WebLinkAboutBLDAB-5 Remodel - BLD Application - 4/28/1977 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED_4-28-77
PERMIT NO. AB- 5
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
Wes Johnson
DIRECTIONS
TO JOB SITE
LEGAL (:1 SEE ATTACHED SHEET)
DESCR. Alderbrook Country Club, Lot #19
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR S & W Contractor 15497 Glenwood Rd. ,S.W.,Port Orchard,Wa. 223-01-SWCON244Q4 876-9348
USE OF
BUILDING Motel Rental
Class of work: ❑ NEW ❑ ADDITION I ALTERATION EXREPAIR ❑ MOVE ❑ REMOVE
Describe work:
Remodel
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS: T
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE Type of Occupancy Division
BY Const. Group
Size of Bldg. No. of Max.
(Total) Sq. Ft. Stories Occ. Load
CONTRACTOR AFFIDAVIT
PERMANENT SEASONAL E.D.NUMBER
I certify that I am a currently registered contractor in RESIDENCE
the State of Washington and I am aware of the MOBILE HOME
ordinance requirements regulating the work for which
the permit is issued and all work done will be in Special Approvals Required Received Not Required
conformance therewith. ZONING
HEALTH DEPT.
Firm PUBLIC WORKS
By
ROAD DEPT.
Lic. No. _Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the N O T I C E
contract or registration law RCW 18.27, and am aware
of the Mason County ordinance requirements for SEPARATE PERMITS ARE REQUIREDFOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be in conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
j1 / SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner L�� " 1� i aGte. r WORK IS COMMENCED.
If
PL1 CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH